The Power of the Pill: Oral Contraceptives and Women's ... - Mail

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742 journal of political economy 1972 hinged on whether the minor was “emancipated” by marriage, parental consent, or statute. But even then, medical services depended on whether the physician believed that it was in the best interests of the patient and was consistent with local practice. Universities and colleges viewed the legal ambiguity in the late 1960s as good reason not to provide family planning services and certainly not to advertise the availability of services offered on an individual basis. Only after the age of majority was lowered and the mature minor doctrine was established did university health services offer family planning to undergraduates and advertise its availability. 24 The availability of family planning services to women when they are in college is a critical input to career change because it occurs when career, marriage, and family decisions are being made. The point is central to our analysis since access to the pill was not a major issue for most women after they were in professional and graduate school. 25 According to the American College Health Association (ACHA), just 12 institutions in 1966 (3.6 percent of those reporting) would prescribe the pill to unmarried students (Barbato et al.1968; Barbato 1971). 26 In 1973, according to an extensive survey of colleges, 19 percent would provide family planning services to students regardless of age and marital status. 27 Because larger schools had a higher fraction providing services, about 42 percent of undergraduates would have been able to obtain such services (Hollis and Lashman 1974). 28 Thus, although in 1966 few student health services would prescribe the pill to unmarried women, by 1973 more than two-fifths of all undergraduates, regardless 24 Yale University was in the forefront and opened a family planning clinic in 1969, prompted by a change in student needs with coeducation (Sarrel and Sarrel 1971). Other institutions rapidly followed. 25 Many people have told us that after the pill’s diffusion, college mentors and those on professional and graduate school acceptance committees took female students more seriously. 26 In the 1970 ACHA survey, about 35 percent of member institutions claimed that they would prescribe the pill to unmarried minors (although a low reporting rate biases this statistic upward). The nonmember institutions had far lower fractions prescribing to all students (12 percent) and even lower reporting rates than member institutions (Hollis and Lashman 1974). 27 No extant records of the 1973 survey exist, so institutional identities are not known. The Wall Street Journal (“The Pill on Campus,” 1970) reported that various universities—among them the University of California at Berkeley, Davis, Los Angeles, Santa Barbara, and San Diego; the Universities of Michigan, Chicago, Illinois, and Washington; and Cornell, Yale, and Northwestern Universities—had recently established, or were about to open, unrestricted family planning clinics for all students. 28 The 1973 survey was done by the National Center for Health Statistics and the ACHA, and it covered 2,984 institutions (92 percent response rate). The 42 percent figure is our estimate based on a table in Hollis and Lashman (1974). Only the 1973 ACHA survey is sufficiently complete to provide an estimate of the fraction of undergraduates who could obtain family planning services on campus.
power of the pill 743 of marital status and age, could receive family planning services on campus, and others could obtain them locally without parental consent. C. The Impact of State Laws on Pill Use Did states with more lenient laws regarding access to contraceptive services by minors have higher pill use by young unmarried women? The NSYW71 is the only data set, of which we are aware, that pertains to the most relevant time period (the very early 1970s) and has information on pill use and state of residence for female teenagers. 29 We have coded the respondent’s state of residence according to whether the state was governed by the mature minor doctrine or had a comprehensive family planning statute, both of which would have enabled young women (16 years and older) to obtain the pill. Twelve states fit that description in 1971, with seven states having a minimum age of 14 or 15 years (see col. 5 of table 2). The estimation in table 3 is given for all never-married women (cols. 1, 3, and 5) and for those who ever had sexual relations (cols. 2, 4, and 6). The effect on pill use of being in one of the nonrestrictive states, relative to the mean of the dependent variable, is quite similar for the two estimations. Included in the regressions are covariates for age, education, current school attendance, religion, race, and census division. States with more lenient regulations regarding minors had greater pill use by young unmarried women. For 15–19-year-olds, pill use was 33–35 percent greater in less restrictive states (cols. 1 and 2); for the 17–19-year-olds, it was 36–40 percent greater (cols. 3 and 4). The increase was largest for all college women (col. 5), perhaps because most university health services carefully followed the law and offered family planning services when the law changed. 30 In states with more permissive laws, young women appear to have had greater access to the pill. But despite our emphasis on changes in laws, we also recognize the porosity of the laws and the role of social norms. Even before 1970, change was “in the air” regarding the rights of young people. The 1967 social security amendment allowing poor women to obtain family planning services without regard to marital status or age was a signal to physicians. States often had ambiguous laws that enabled county health departments to extend contraceptive services to all women 29 The NSAF76 does not have state of residence, and, even if it did, it would be too late. 30 The magnitudes of the estimated effects of a nonrestrictive state law in cols. 1–4 of table 3 are not much affected by adding state per capita income to the regressions. The coefficients on the state law variable for the subsample of college women in cols. 5 and 6 are reduced in magnitude, and the standard errors increased substantially, by the inclusion of state per capita income. For nonsouthern states, the income and the state law variables are highly correlated.
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